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action-alert-how-you-can-help-cancel-medicare-payment-cutsAction Alert! How You Can Help Cancel Medicare Payment CutsLatest_NewsShared_Content/News/Membership_Memo/2022/december-9/action-alert-how-you-can-help-cancel-medicare-payment-cuts<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/medicare-cta-1-645x425px.png" class="pull-right" alt="Protect patient access to care illustrated graphic" /></div> <h5>December 9, 2022</h5> <h2>Action Alert! How You Can Help Cancel Medicare Payment Cuts </h2> <p>If Congress fails to act soon, physician Medicare payments will be cut by 4.5% on Jan. 1, 2023, due to regulatory changes enacted by the Centers for Medicare and Medicaid Services. Cuts of this magnitude would severely impede patient access to care and place further strain on an already stressed practice community. When adjusted for inflation, Medicare physician payments have dropped by 22% from 2001 to 2021. Physicians simply cannot afford to operate under the current payment system.</p> <p>We have been raising the red flag over these cuts for months-and lawmakers are beginning to listen. But we need to keep the pressure on. The "lame duck" session of Congress is always a chaotic time with numerous priorities and interests vying to be included in the final must-pass package. It's urgent that the physician community push back on these cuts and ensure that physicians and patients don't get lost in the end-of-year shuffle.</p> <p><strong>What can you do to help cancel the cuts:</strong></p> <ol> <li>Contact your lawmakers through this link and share it with your colleagues: <a href=""></a></li> <li>Share this link with your patients: <a href=""></a></li> <li>Reach out to your member of Congress to schedule a meeting/phone call. <ul> <li>Download the AMA'sCancel the Cuts Action Kit: <a href=""></a></li> <li>Contact <a href=""></a> if you need help connecting with your member of Congress or need tips on how to effectively communicate your message and prepare for your meeting.</li> </ul> </li> </ol> <p>Time is running out. <a href="">Contact Congress now</a> and demand that they protect patients and practices by canceling these devastating Medicare cuts in their entirety before the clock strikes zero.</p> </div>12/9/2022 12:00:00 AM1/1/0001 12:00:00 AM
cms-announces-rulemaking-to-improve-prior-authorizationCMS Announces Rulemaking to Improve Prior AuthorizationLatest_NewsShared_Content/News/Membership_Memo/2022/december-9/cms-announces-rulemaking-to-improve-prior-authorization<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/administrative-burden-645x425px.jpeg" class="pull-right" alt="administrative burden illustration" /></div> <h5>December 9, 2022</h5> <h2>CMS Announces Rulemaking to Improve Prior Authorization </h2> <p>In a breaking development this week, the Centers for Medicare and Medicaid Services announced the commencement of rulemaking to streamline prior authorization.</p> <p>The proposed rule shares many elements of the Improving Seniors' Timely Access to Care Act (S. 3018/S.R. 3173)<em>, </em>national legislation for improving prior authorization supported by the American Medical Association and the WSMA. Rule provisions include concepts such as tightening turnaround times and use of an electronic portal among others and would apply to Medicaid and Medicare Advantage plans. <a href="">Read the CMS press release for details</a>.</p> <p>Prior authorization is a top advocacy priority for the WSMA and we continue to push at all levels for improvements to the process in the interest of expediting access to care for patients and relieving administrative burden for physicians. We're pleased to see CMS take action on the issue with rulemaking.</p> <p>At the state level, the WSMA has been formulating legislation for the 2023 legislative session that would effect similar improvements to prior authorization among state-regulated health plans. WSMA staff is assessing how our legislative proposal intersects with the draft CMS rule. We will continue highlighting this issue in Olympia and the "other" Washington and will keep members apprised of developments.</p> </div>12/9/2022 12:00:00 AM1/1/0001 12:00:00 AM
prior-authorization-abortion-access-medicaid-rates-top-list-of-2023-wsma-legislative-prioritiesPrior Authorization, Abortion Access, Medicaid Rates Top List of 2023 WSMA Legislative PrioritiesLatest_NewsShared_Content/News/Membership_Memo/2022/december-9/prior-authorization-abortion-access-medicaid-rates-top-list-of-2023-wsma-legislative-priorities<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/ls-2018-01-245-straightened-645x425px.jpeg" class="pull-right" alt="Capitol building" /></div> <h5>December 9, 2022</h5> <h2>Prior Authorization, Abortion Access, Medicaid Rates Top List of 2023 WSMA Legislative Priorities</h2> <p>WSMA's government affairs team will highlight these and other WSMA legislative priorities during a webinar on <a href="">Tuesday, Dec. 13, at noon</a>. The hour-long session will serve as an opportunity for WSMA members to preview the 2023 state legislative session that begins in January and learn more about WSMA's legislative priorities and the health care policy landscape. Members are encouraged to participate-there will be time during the session for you to provide feedback on any concerns or issues you or your practice are facing. Register for the webinar <a href="">online</a>.</p> <p>Medicaid reimbursement, prior authorization, and ensuring access to abortion and reproductive health care services will also be among the priority fiscal and policy issues that will be the focus of the 2023 WSMA Legislative Summit, scheduled for Feb. 3, in person at the Capitol. We hope you will don your white coats and join us in Olympia to help advocate for these WSMA legislative priorities-<a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/Legislative_Summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5">registration for the Feb. 3 event is free</a> (lunch will be provided).</p> </div>12/9/2022 12:00:00 AM1/1/0001 12:00:00 AM
single-dose-vials-of-bivalent-covid-19-vaccine-now-availableSingle-Dose Vials of Bivalent COVID-19 Vaccine Now AvailableLatest_NewsShared_Content/News/Membership_Memo/2022/december-9/single-dose-vials-of-bivalent-covid-19-vaccine-now-available<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/istock-1372360890-645x425px.jpeg" class="pull-right" alt="physician administering vaccine" /></div> <h5>December 9, 2022</h5> <h2>Single-Dose Vials of Bivalent COVID-19 Vaccine Now Available</h2> <p>Updated single-dose vials of bivalent Pfizer COVID-19 vaccine for people 12 years of age or older are now available in limited quantities to jurisdictional and federal entity administration partners, per an announcement from the U.S. Department of Health and Human Services. This limited introduction of single-dose vials is designed to allow for the administration of updated COVID-19 vaccines in more places, such as physicians' offices or mobile clinics that may not have the capacity or demand to keep multi-dose vials of COVID-19 vaccine on hand.</p> <p>Single-dose vials will be available at a minimum order quantity of 50 doses. Awardees will be limited to not more than 150 single-dose vials per order. HHS is encouraging eligible partners to direct their orders of single-dose vials to sites such as doctors' offices or community health centers that have consistently low or irregular patient traffic or might not otherwise offer the COVID-19 vaccine. Partners are strongly encouraged to consider equity and consult resources, such as <a href="">national data published by CDC</a> on updated vaccine uptake by race and ethnicity.</p> <p>HHS offers a <a href="javascript://[Uploaded files/For Members/aspr-one-dose-vial-1pg.pdf]">quick fact sheet</a> with specifications and ordering information for the single-dose vial Pfizer bivalent booster.</p> </div>12/9/2022 12:00:00 AM1/1/0001 12:00:00 AM
board-of-naturopathy-moves-forward-with-non-surgical-cosmetic-procedures-rulemakingBoard of Naturopathy Moves Forward with Non-Surgical Cosmetic Procedures RulemakingLatest_NewsShared_Content/News/Membership_Memo/2022/november-23/board-of-naturopathy-moves-forward-with-non-surgical-cosmetic-procedures-rulemaking<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/november/mortar-pestle-645x425px.jpeg" class="pull-right" alt="mortar and pestle" /></div> <h5>November 23, 2022</h5> <!-- **************************NEW ARTICLE****************************** --> <h2>Board of Naturopathy Moves Forward with Non-Surgical Cosmetic Procedures Rulemaking</h2> <p>Despite overwhelming opposition from the physician community and a division within the naturopathic community, the Washington State Board of Naturopathy voted to move forward with its years-long effort to include non-surgical cosmetic procedures within their scope of practice. The proposal was slimmed down to focus on the use of botulinum toxin. Previous iterations included the use of dermal fillers and other inert substances.</p> <p>The board will likely revisit this rulemaking during a <a href="[@]wsma/advocacy/legislative___regulatory/understanding_the_regulatory_process/wsma/advocacy/legislative_regulatory/understanding_the_regulatory_process/understanding_the_regulatory_process.aspx?hkey=0695da42-202f-458b-8127-cbfc07207c56">CR-102</a> hearing at its Feb. 10 meeting. The WSMA will attend the meeting to again share our patient safety concerns and our positions that the rulemaking is inconsistent with naturopathic medicine and that the Legislature should set a profession's scope of practice. The board is still receiving public testimony on this issue, and we encourage physicians and physician assistants to share their opposition to the proposal by emailing <a href=""></a>.</p> <p>The WSMA would like to thank WSMA President Katina Rue, DO; Chris Chambers, MD; Andrea Kalus, MD; Kendra Bergstrom, MD; and Kate Impastato, MD, for delivering expert testimony on this issue, and for clearing their schedules to accommodate the meeting on short notice. We'd also like to thank the Washington Academy of Eye Physicians and Surgeons, Washington Society of Plastic Surgeons, Washington State Dermatology Association, and the American Academy of Dermatology for their continued partnership on this rulemaking.</p> <p>If you have questions or thoughts on this rulemaking, please contact <a href="">WSMA Associate Policy Director Billie Dickinson</a> at <a href=""></a>.</p> </div>11/23/2022 12:00:00 AM1/1/0001 12:00:00 AM
in-new-survey-practices-continue-to-grapple-with-economic-hardshipIn New Survey, Practices Continue to Grapple with Economic HardshipLatest_NewsShared_Content/News/Membership_Memo/2022/november-23/in-new-survey-practices-continue-to-grapple-with-economic-hardship<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/november/stethoscope-dollar-sign-645x425px.jpeg" class="pull-right" alt="Stethoscope in shape of a dollar sign" /></div> <h5>November 23, 2022</h5> <h2>In New Survey, Practices Continue to Grapple with Economic Hardship</h2> <p>Results from a new survey from the WSMA and the Washington State Medical Group Management Association make clear that physician practices and clinics in Washington continue to face severe economic strain, putting at risk the ability of patients to access care in communities across the state.</p> <p>Throughout the pandemic, the WSMA and the WSMGMA have jointly conducted economic impact surveys of physician clinics in Washington state to gauge the impact of the pandemic and pandemic-associated pressures on patient access to care and to help inform our advocacy on behalf of the physician community.</p> <p>A few key highlights from the latest survey, which featured responses from 82 physician practices:</p> <ul> <li>89% have experienced staffing shortages due to COVID-19. Of those: <ul> <li>77% are experiencing challenges filling administrative staff positions.</li> <li>75% are experiencing challenges filling medical assistant positions.</li> <li>40% are having trouble filling nursing positions.</li> <li>33% are having trouble hiring physicians.</li> </ul> </li> <li>46% have had to reduce patient access. Almost 40% have had to reduce their office hours, as well as services and treatments offered to patients.</li> <li>93% have less than four months days cash on hand. Industry standard is 18 weeks.</li> <li>51% said that inflation has had a significant impact on their practice, while 44% said that inflation has had some impact on their practice. Of those impacted by inflation: <ul> <li>89% noted the rising cost of labor.</li> <li>Over 30% have reduced office hours, patient access, and services/treatments offered to patients in response.</li> </ul> </li> <li>Just over 50% are not confident they'll be able to provide the same level of patient access a year from now.</li> <li>46% have had to limit Medicaid panels due to their financial situation. The most commonly cited solution: increasing Medicaid reimbursement rates to Medicare rates.</li> </ul> <p>Thank you to the practices that responded to the survey. The WSMA will use these data points as a snapshot of what is happening in practices across the state in its discussions with policymakers.</p> </div>11/23/2022 12:00:00 AM1/1/0001 12:00:00 AM
a-tale-of-two-ceosA Tale of Two CEOsLatest_NewsShared_Content/News/Latest_News/2022/a-tale-of-two-ceos<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2022/november-december/nov-dec-2022-reports-cover-645x425px.jpeg" class="pull-right" alt="cover illustration for WSMA Reports November/December 2022" /></div> <h5>November 17, 2022</h5> <h2>A Tale of Two CEOs</h2> <h5> <em>Members only; sign-in required.</em> </h5> <p> By John Gallagher </p> <p> As one of the country's leading integrated health systems, UW Medicine stands at the nexus of medical research, clinical care, teaching, and community service in Washington state and the Pacific Northwest. The UW Medicine footprint in the region is broad and deep, incorporating the University of Washington School of Medicine, the five-state WWAMI physician training program, clinically integrated components such as UW Physicians, UW Medical Center, Harborview Medical Center, and Fred Hutchison Cancer Center, to name a few, and an extensive list of affiliations and partnerships. </p> <p> This year, Paul Ramsey, MD, stepped down as the CEO of UW Medicine after 25 years of leading the health system giant, passing the mantle to UW Medicine Chief Medical Officer Tim Dellit, MD, who stepped up to serve as interim CEO for two years. As a tremendous legacy and responsibility is passed from one experienced leader to another, the two physicians sat with WSMA Reports to share their thoughts and some wisdom with our readers. </p> <p> For a quarter of a century, Paul Ramsey, MD, had the ideal seat to observe the rapid changes in medicine. As CEO of UW Medicine and dean of the University of Washington School of Medicine, both in Seattle, Dr. Ramsey was able not just to watch how the profession was changing in Washington and nationally but also to help shape those changes. </p> <p> During his tenure, UW Medicine emerged as a powerhouse in medical research, earning about $1 billion in federal research grant funding in 2020, the second highest of any medical school in the nation. At the same time, its clinical practice grew. In 2010, UW Medicine had 18,300 employees; by the time of Dr. Ramsey's retirement in 2022, that number had grown by 10,000. The combination allowed UW a unique opportunity to advance research to clinical applications that few other systems could rival. </p> <p> Yet, at this stage of his career, Dr. Ramsey prefers to focus on the future, not reflect upon the past. </p> <p> "I'd rather look forward at this point than look back," he says. "When one retires, the tendency is to look back, but I think we are at a really critical point in the history of medicine. We have substantial challenges, but we also have the most important opportunities in the history of medicine in my 50-year career." </p> <p> Dr. Ramsey lists three opportunities that the Washington physician community can take advantage of in the coming years. One is to advance health care equity. </p> <p> "We've recognized for many years the need to make progress with health care equity," Dr. Ramsey says. "Now that we have the ability to measure care and outcomes of care, we can develop specific solutions while advancing health care equity overall." </p> <p> The second opportunity that Dr. Ramsey cites builds on advances that he has seen accelerate over his career. "I don't think anyone would disagree that research in medicine is at its best, more so than at any time in history," he says. "The technology, including computational technology, is moving faster than ever before. During the pandemic, we showed that we can accelerate that directly to clinical care. No one would have predicted that we would have had fundamental changes so quickly." </p> <p> While the introduction of mRNA vaccines is one example of the huge leaps in medical research, it is hardly the only one. Dr. Ramsey notes that cancer research has also been accelerating the pace of treatment. "There are basically opportunities all over medicine to take advantage of these truly extraordinary breakthroughs in basic science and apply those to treatment and prevention," he says. </p> <p> Finally, there are the opportunities happening due to the rapid changes in care delivery, also spurred by technological advances. While the COVID-19 pandemic opened the profession's eyes to the widespread utility of telemedicine, that's not the only improvement in the delivery of care that holds promise. </p> <p> "It's also using the functionality of electronic health records and electronic connections to improve care by providing more accessible care at a more affordable price and at a more convenient location," says Dr. Ramsey. "I'm optimistic about what digital health can mean going forward." </p> <p> Dr. Ramsey doesn't downplay the challenges that the profession faces. "The challenges are very real, and the challenges are among the most significant that I've seen in my career." He lists the rapidity with which change is happening, physician burnout, the ongoing toll from the pandemic, and the financial burdens facing systems and physicians. </p> <p> Yet even in the face of these challenges, Dr. Ramsey is convinced that Washington state, and especially UW Medicine, will be able to capitalize on the advances that he has described. </p> <p> "I believe that UW Medicine is extremely well-positioned to lead with taking advantage of the opportunities, and I believe that the state is in that position," he says. "We have been building to these opportunities for a number of years." He notes that more than 20 years ago, the board of UW Medicine developed a single mission to improve the health of all people, setting it on a path to become one the nation's leading integrated clinical, research, and learning health systems. </p> <p> As for Dr. Ramsey, if he had it to do over again, he just wishes he could be doing it now. "The bottom line for me is that this is such a time for opportunity and exciting change that I wish I was starting over again." </p> <p> In his recent roles as chief medical officer at UW Medicine and president of UW Physicians, Tim Dellit, MD, was well acquainted with the problem of the health care worker shortage. Physician burnout, nursing shortages, and difficulties in filling positions, compounded by the need for greater workforce diversity, had been part and parcel of medicine for some timeonly to be exacerbated by the COVID-19 pandemic. </p> <p> "It's a period of time within our state and nationally of significant staffing challenges not just of physicians, but nursing and other members of the health care team," says Dr. Dellit. "Hospitals and physician practices are experiencing significant financial challenges and rising labor costs." </p> <p> Now, as the interim CEO of UW Medicine after taking the reins from Paul Ramsey, MD, Dr. Dellit will have the opportunity to work even more closely to address the vexing problems facing the physician workforce and the pathways to the profession. </p> <p> Fortunately, UW Medicine has a unique vehicle for addressing physician training. Roughly 50 years ago, the University of Washington School of Medicine formed a multi-state medical education program with Washington, Alaska, Montana, and Idaho (Wyoming would join in 1996). The program, known by its acronym WWAMI, offers a communitybased medical education program. </p> <p> "The primary goal is to increase access to care in rural and underserved regions and increase the physician workforce, especially primary care physicians, in each of those states," says Dr. Dellit. "If students are trained locally through community-based education, they are more likely to practice locally and be part of that community. That is very unique compared to any other medical school in the country." </p> <p> WWAMI has been successful in helping fill the shortage of physicians in rural areas. "Practicing in a rural environment can be very different," Dr. Dellit acknowledges. "This is an opportunity for our students to have a number of tracks that give them an immersion experience to understand the practice of medicine in those environments and build relationships with the local community." </p> <p> The program also allows residents to receive training in underserved areas, including through partnerships with local health care systems, again with the hope that they will remain to practice there once they complete their residency.</p> <p>One measure of the value of the program in meeting a workforce need is the number of students who choose primary care: more than 50%. "That's a testimony to the focus we put on primary care and the relationships students develop with the local communities," says Dr. Dellit.</p> <p> Dr. Dellit says that WWAMI is constantly reviewing how it can address the changes that are occurring in each of the states it serves.</p> <p>"We partner with the organizations within each of the states to look at the ways to meet the needs of the local community," he says. "As the health care landscape in each of those states evolve, we continue to look at how to meet the needs."</p> <p> For example, increasing needs in some states have led to discussions about increasing the class size at some WWAMI sites. Dr. Dellit stresses that any changes are done in partnership with local state organizations and are dependent on having enough clinical training sites for the students to meet the accreditation standards. </p> <p> "This isn't something that we can do alone," he says. "We work in partnership with the local institutions, medical associations, and physicians to support what is best for each state." </p> <p> Dr. Dellit is also grateful for the preceptors, including WSMA members, who participate in the program. "We appreciate all the individuals who have been willing to supervise and support students across the state," he says. "We can't do it alone. We rely upon our physician preceptors across the WWAMI region." </p> <p> Yet Dr. Dellit also recognizes that increasing medical training and professional pathways to meet workforce needs is a long-term project and that WWAMI alone can't solve these challenges without strong partnerships. </p> <p> "One of the unfortunate impacts of the pandemic is that some health care systems have decreased their ability to train students given the current financial challenges," he says. "How do hospitals continue their mission and support training the next generation of professionals? That's going to be an issue that will need to be addressed right now." </p> <p> Still, WWAMI at least provides hope in a challenging environment. </p> <p> "The positive is that we continue to see broad community support for the partnership in each of our training sites," Dr. Dellit says. "We're always learning about the unique needs of each of the different locations across the Northwest and working in partnership to address them. Despite the challenges we're facing, we are working collectively to decrease health care inequities, increase the workforce, and make sure the workforce reflects the community that it serves." </p> <p> <em>John Gallagher is a freelance writer specializing in health care.</em> </p> <p> <em>This article was featured in the November/December 2022 issue of WSMA Reports, WSMA's print magazine.</em> </p> </div>11/17/2022 12:00:00 AM1/1/0001 12:00:00 AM
solving-the-workforce-puzzleSolving the Workforce PuzzleLatest_NewsShared_Content/News/Latest_News/2022/solving-the-workforce-puzzle<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img alt="cover illustration for WSMA Reports November/December 2022" src="/images/Newsletters/Reports/2022/november-december/nov-dec-2022-reports-cover-645x425px.jpeg" class="pull-right" /></div> <h5>November 17, 2022</h5> <h2>Solving the Workforce Puzzle</h2> <p> By Garrett Jeffery, DO </p> <p> The patient had suffered a setback toward the beginning of the COVID-19 pandemic. Then, to my dismay, the setback became a full-blown acute crisis as the pandemic wore on. What made this case particularly vexing for me was that, for this patient, my medical training was useless. The patient was my clinic. </p> <p> That acute crisis was the departure of 13 of our 20 total physician and clinician positions across two primary care clinics over the course of three years. Exit interviews highlighted many different motivations, such as lateral moves to outside organizations, semi-retirement, career advancements, etc. </p> <p> We have been anticipating physician shortages in the U.S. for decades. The global pandemic and the great many additional stressors facing our populace were understandably not a part of those initial forecasts. Yet, the resulting "great resignation" and all the supposed factors contributing to the phenomenon have not spared our health care sector. </p> <p> My clinics are not unique to this seeming trend in resignations across Washington. Responses to address the widening gaps in workforce have been varied. One strategy explored locally was to begin partnering with local technical colleges. Unfortunately, they have experienced a decline in applicants that has resulted in vacancies in their training programs for medical assistants. Without identifying and addressing the driving factors for these shortages, we may be in for a long struggle. </p> <p> Temporary hires are not the answer. The dramatic escalation of the costs for obtaining nursing staff would be difficult to imagine a decade ago and it is telling of the situation we are in. This is not a sustainable model. This catabolic state, so to speak, of our finite health care dollars cannot support our state's long-term need for nurses, medical assistants, behavioral health professionals, and other technical staff. </p> <p> We have seen legislation such as Senate Bill 5751 and House Bill 1868 advanced earlier this year in an effort by unions to advocate for workforce shortages. These short-sighted proposals would directly reduce access when it is needed most and do nothing to address what is needed most: increased training opportunities to increase the number of graduates. </p> <p> While a good portion of graduates from Washington's three medial schools are retained at local training sites, opportunity exists to expand the number of training sites. Opportunity also exists to retain physicians after completion of residency and fellowship training. </p> <p> How does Washington state further establish itself as the destination to practice medicine? Ideas abound, including investment in postgraduate education, tort reform, and reducing prior authorization burden on practicing clinicians. Student loan reimbursement may be an important deciding factor for these new graduates. Investing in loan repayment programs in Washington state would expand the practice options for this cohort. </p> <p> To address the staffing crisis at my clinic, I stepped into the role of section chief of the two clinics. We hired new management staff with an emphasis on promoting a supportive culture to improve physician and caregiver engagement. With recruiting incentives and an apprenticeship program, our staffing levels and retention have improved, yet we continue to feel the attrition and lag time for new applicants. </p> <p> If we compare this to a quality improvement initiative, then we need to better understand the key drivers before we can develop our interventions. This may include funding a study of resigned staff and physicians to learn what impacts their decisions. In the interim, we will need to rely on prioritizing legislation to broadly invest in a highly educated and trained physician and health professional workforce to facilitate the delivery of high-quality and efficient care for all our communities-i.e., more time spent caring for patients, and less time on our ailing practices. </p> <p> <em>Garrett Jeffery, DO, FAAFP, is section chief of PeaceHealth Medical Group Family Medicine, NW Network.</em> </p> <p> <em>This article was featured in the November/December 2022 issue of WSMA Reports, WSMA's print magazine.</em> </p> </div>11/17/2022 12:00:00 AM1/1/0001 12:00:00 AM
2023-medicare-part-b-final-rule-features-expected-payment-reductions2023 Medicare Part B Final Rule Features Expected Payment ReductionsLatest_NewsShared_Content/News/Membership_Memo/2022/november-11/2023-medicare-part-b-final-rule-features-expected-payment-reductions<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/november/medicare-barcode-645px.jpg" class="pull-right" alt="Medicare barcode graphic" /></div> <h5>November 11, 2022</h5> <h2>2023 Medicare Part B Final Rule Features Expected Payment Reductions</h2> <p>The Centers for Medicare & Medicaid Services has released the <a href="">final rule for the CY 2023 Medicare physician fee schedule</a>. As expected, the rule contains provisions that, when combined with other cuts to the program, amount to about a 10% reduction in Medicare physician payments starting Jan. 1. The WSMA, the American Medical Association, and much of organized medicine are strongly opposing these cuts and urging congressional intervention before the end of the year. Join your voice to ours by <a href="">contacting your congressional representatives today</a>.</p> <p>In the rule, the 2023 Medicare conversion factor will be reduced by approximately 4.48% from $34.61 to $33.06. This incorporates the budget neutrality adjustments, which are required by law to ensure payment rates for individual services don't result in changes to estimated Medicare spending, the required statutory update to the conversion factor for 2023 of 0%, and the expiration of the 3% supplemental increase to physician fee schedule payments for 2022.</p> <p>In addition to the final rule's 4.48% reduction for physician services, congressional Pay-As-You-Go rules require an automatic 4% cut in the program starting in 2023 as a result of new federal spending having nothing to do with physicians. Unless <a href="">Congress acts by the end of the year</a>, cuts in physician Medicare payments will total 8.42% in 2023, which would severely impede patient access to care due to the forced closure of physician practices and put further strain on those that remained open during the pandemic.</p> <p>In other top lines, courtesy of the Medical Group Management Association, the final rule:</p> <ul> <li>Finalizes implementation of provisions of the Consolidated Appropriations Act, 2022 that extend the application of certain Medicare telehealth flexibilities for an additional 151 days after the end of the COVID-19 public health emergency, such as allowing telehealth services to be furnished to patients in their homes.</li> <li>Extends flexibilities to permit split/shared E/M visits to be billed based on one of three components (history, exam, or medical decision-making) or time until 2024.</li> <li>Expands access to behavioral health by permitting marriage and family therapists, licensed professional counselors, and others to furnish behavioral health services under general, instead of direct, supervision.</li> <li>Maintains the MIPS performance threshold at 75 points for the 2023 MIPS performance year/2025 payment year.</li> <li>Adds five new MIPS Value Pathways related to nephrology, oncology, neurological conditions, and promoting wellness for voluntary reporting beginning in 2023.</li> <li>Creates an advanced incentive payment pathway for certain low-revenue, new entrant accountable care organizations to bolster participation in the Medicare Shared Savings Program.</li> </ul> <p>For more analysis of the rule's provisions, <a href="">see this AMA article</a>. Additional information about the final rule is available in the <a href="">2023 Medicare Physician Fee Schedule Final Rule fact sheet</a>.</p> </div>11/11/2022 12:00:00 AM1/1/0001 12:00:00 AM
election-update-democrats-signal-strong-showingElection Update: Democrats Signal Strong ShowingLatest_NewsShared_Content/News/Membership_Memo/2022/november-11/election-update-democrats-signal-strong-showing<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/november/i-voted-stickers-645x425px.jpg" class="pull-right" alt="I Voted stickers" /></div> <h5>November 11, 2022</h5> <!-- **************************NEW ARTICLE****************************** --> <h2>Election Update: Democrats Signal Strong Showing</h2> <p>After months of buildup and drama, the 2022 midterm elections were held this past Tuesday, Nov. 8. Early returns show Democrats picking up a seat in our state's congressional delegation and maintaining wide majorities in both chambers of the Washington State Legislature. But "early" is the operative word as our state's mail-in voting system yields late ballot returns that can shift races substantially. The <a href="">Washington Secretary of State's website</a> displays the latest results, and your WSMA will continue to provide election updates as late votes are counted (below results are current as of Thursday evening).</p> <p>Top of mind for the WSMA are the two physician candidates in the field. Rep. Kim Schrier (D-8<sup>th</sup> Congressional District) was staked to a 52-48 lead in her swing district reelection effort. Lelach Rave, MD, a pediatrician running as a Democrat for an open seat in North Seattle's 46<sup>th</sup> Legislative District, was trailing in her race by a margin of 56-43.</p> <p>In other high-profile races, Democrat Sen. Patty Murray defeated Republican challenger Tiffany Smiley, Democrat Marie Gluesenkamp Perez is leading Republican Joe Kent 51-49 in Southwest Washington's 3<sup>rd</sup> Congressional District, and Democrat Steve Hobbs is leading independent Julie Anderson by a margin of 49-47 for secretary of state.</p> <p>If Tuesday's vote counts were binding, Democrats would be adding to their already wide majorities in Olympia, picking up one seat in the state Senate and three seats in the state House. After the first day of counting there were more than 600,000 votes yet to be counted, representing around 27% of the total ballots received. Recent experience shows that Republicans tend to vote later, and if the pattern holds it's likely many races will tighten and a few will flip, likely yielding a dynamic in Olympia that's similar to what we've seen in recent years.</p> <p>Campaign themes were well-worn by the time voters cast their ballots, with Republicans focusing on concerns about inflation and public safety, while Democrats highlighted the importance of ensuring access to abortion and reproductive health care services. Republican hopes for a "red wave" were tempered by results in August's primary election that didn't live up to their expectations, though they still had aims of making gains in the state Legislature that don't look to be materializing.</p> </div>11/11/2022 12:00:00 AM1/1/0001 12:00:00 AM
in-direct-appeal-washingtons-secretary-of-health-urges-health-care-to-promote-covid-19-boostIn Direct Appeal, Washington's Secretary of Health Urges Health Care to Promote COVID-19 BooLatest_NewsShared_Content/News/Membership_Memo/2022/november-11/in-direct-appeal-washingtons-secretary-of-health-urges-health-care-to-promote-covid-19-boost<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/november/woman-covid-vaccine-645x425px.jpg" class="pull-right" alt="Woman receiving COVID-19 vaccine" /></div> <h5>November 11, 2022</h5> <h2>In Direct Appeal, Washington's Secretary of Health Urges Health Care to Promote COVID-19 Booster</h2> <p>The WSMA continues to encourage physician practices and clinics to incorporate the COVID-19 vaccines into practice workflows and employ effective strategies to talk with their patients about the vaccine, <a href="">offering education and resources to help</a>. This week, Washington Secretary of Health Umair A. Shah, MD, MPH, issued a letter to physicians and the health care community regarding bivalent COVID-19 boosters, underlining the need for greater attention and availability of these life-saving vaccines, noting that many patients are having difficulty scheduling timely appointments to receive it.</p> <p> The letter goes on to request the following actions: </p> <ol> <li>"Encouraging your patients and staff members alike to get the bivalent booster if they are eligible by:</li> <ol style="list-style-type: lower-alpha;"> <li>Contacting and/or sending reminder notices to your patients who are eligible.</li> <li>Offering walk-in hours or clinics for patients in addition to scheduled appointments.</li> <li>Holding employee vaccine clinics, offering work time of other benefits for your employees to get vaccinated to ensure your workforce stays healthy this winter.</li> </ol> <li>Making it easier for your patients to find appointments. <a href="">Find a guide on doing this here</a>.</li> <ol style="list-style-type: lower-alpha;"> <li>Identify strategies to increase availability of appointments for your patients, especially in locations with high demand (in some areas, this can mean the next available COVID-19 booster appointment is several weeks out).</li> </ol> <li>Offering the COVID-19 booster to patients who are in your facility for other types of appointments. Remember, you can administer COVID-19 vaccine at the same time as the flu shot, and we strongly encourage you to recommend both vaccines to your patients. Combining appointments is convenient for your patient and can save staff time and resources.</li> <li>Joining the <a href="">Power of Providers (POP) Initiative</a> launched last year and enlisting over 60,000 members of Washington's health care community since its inception. Please share POP resources available on our website with your patients and staff, including links to clinical information, patient handouts, and training videos."</li> </ol> <h3>Let the WSMA help</h3> <p>If you haven't already, it's time to embed the COVID-19 vaccine into routine preventive care in your practice and engage patients in conversations about the vaccine. To help, the WSMA offers a two-part WSMA/DOH COVID-19 Vaccines Webinar Series. <a href="[@]wsma/education/on_demand_webinars/covid-19-vaccines-webinar-series.aspx">Begin CME activity</a>. This activity has been approved for <em>AMA PRA Category 1 Credit</em>â„¢.</p> </div>11/11/2022 12:00:00 AM1/1/0001 12:00:00 AM
member-profile-tamara-tammie-chang-mdMember Profile: Tamara 'Tammie' Chang, MDLatest_NewsShared_Content/News/Latest_News/2022/member-profile-tamara-tammie-chang-md<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2022/november-december/member-profile-website-image-chang-645x425px.png" class="pull-right" alt="Member Profile: Tamara Chang, MD graphic" /></div> <h5>November 8, 2022</h5> <h2>Member Profile: Tamara 'Tammie' Chang, MD</h2> <p> <strong>Works at:</strong> Mary Bridge Children's Hospital and MultiCare Health System </p> <p> <strong>How long in practice: </strong>10 years </p> <p> <strong>Specialty:</strong> Pediatric hematology oncology </p> <p> <strong>Why WSMA: </strong>I didn't discover the WSMA until my boss and I were invited to present our MultiCare physician and advanced practitioner wellness work at the WSMA Leadership Development Conference at Lake Chelan in May. Right away, I could sense that these were my people: Physicians who care deeply about our profession, about our communities, about advocating not only for the health of the people we serve, but also for the well-being of physicians as a medical profession. </p> <p> <strong>Proud moment in medicine:</strong> What drives me today came out of the darkest time in my life and career, only three years ago. I was severely burned out, severely depressed and suicidal, and nearly tried to drive my car off a cliff coming home from work after a long and difficult end-of-life discussion with a young patient's family. That moment-while not my proudest in medicine-became the catalyst for everything I do and who I am today. It propelled me into a life of service and vulnerability, dedicated to transforming the culture of medicine and improving the well-being of my fellow physicians. I'm committed to changing the stigma of mental illness and our silent struggle in medicine, and to improving the practice of medicine for my peers, colleagues, and future generations of people in medicine. I am especially driven to improve the practice of medicine for women, who disproportionately experience burnout and depression and are quitting medicine at record rates. </p> <p> <strong>Top concerns in medicine:</strong> I am worried about the longevity and the future of our medical profession. Health care has changed so dramatically over the last 30 years and continues to change rapidly. We are experiencing the highest rates of burnout, mental illness and distress among physicians and health care workers in history. I believe we are at a tipping point in U.S. health care today. The issues of burnout and mental illness have existed for physicians for decades, but I believe that one silver lining of the pandemic was that it exacerbated these issues and brought them front and center. The worker shortages and financial crises we are experiencing universally in health care will force change to happen. I am hopeful that this will create a change that that enables a practice and delivery of medicine that will be in the greatest service of the well-being of our patients and those caring for patients. </p> <p> <strong>What inspires me about being in medicine:</strong> Nowhere else have I been surrounded by such dedicated, giving, and compassionate human beings. Our work is humbling, and when I have a chance to sit down and talk with colleagues about what it is that inspires them about being in medicine, a common theme emerges: We are driven-almost without exception-by a calling to serve others, our communities, and each other. I continue to care for pediatric hematology oncology patients half-time, while I dedicate the rest of my time to serving in my roles as the medical director of the wellness program for MultiCare, co-founder of Pink Coat, MD, founder and director of the American Medical Women's Association's ELEVATE Leadership Development Program, working with physicians as a leadership coach, writing books, creating podcasts, and speaking-because I care so deeply about my colleagues, my friends, my peers, and our profession. </p> <p> <strong>Why my specialty:</strong> Many of us have pivotal moments during our education when it becomes clear what we must do. Discovering pediatric hematology/oncology was just that for me. As a fourth-year medical student, I thought I wanted to become an adult oncologist. I remember the moment when it sunk in for me that, yes, pediatric hematology/oncology was what I had to do. It was an encounter with a kind and giving pediatric neuro-oncologist at Brown University, where I went to medical school. I still remember the conversation as we sat in a hospital room with a young mother holding her baby girl who had a brain tumor. There was something precious and spiritual about that moment. I will never forget the compassion of the physician, or the preciousness of that encounter. I live for moments like these. I know that I am at my best as a physician, and as a human being, when I am with parents and their children, having some of the most difficult discussions and navigating the scariest times of lives. I live to create a safe, compassionate space for others. </p> <p> <strong>If I weren't a doctor, I'd be:</strong> As a kid and teenager, I thought I wanted to become a pianist. I still deeply love music, the creativity and expression through music that is not possible through words. So, maybe I'd be a pianist. I'd only play Rachmaninoff, Brahms, Busoni, Chopin, and Beethoven. And maybe I'd also be a writer. </p> <p> <strong>Spare time: </strong>The happiest moments in my day are when I'm with my husband, Matthew, and our two golden retrievers, Gus and Toby, hiking outdoors. We also have a cat, Mimi, who loves to cuddle up by us on the couch. </p> <p> <strong>My three goals for the year ahead:</strong> A personal goal has been to give a TEDx talk to raise public awareness and provide solutions for the silent struggle of women doctors. That goal came true in November. Goals for the year ahead? To create a large-scale documentary on the silent struggle of women doctors, to continue to live in alignment and integrity with my "why" and my purpose of transforming the culture of medicine for all of us, and to remain true to taking the long view with this work. The work we are collectively doing together now will take years, decades, and generations. It is worthy of a lifetime of commitment. </p> <p> <strong>Something people might not know about me: </strong>I was a competitive open rhythm ballroom dancer in college, but don't ask me to try to dance now! I was a Brown Outdoor Leadership Training participant, leader, and leader trainer in college. My deep desire to lead from a place of love, acceptance, compassion, partnership, collaboration, and teamwork is thanks to BOLT. </p> <p> <strong>Pet peeves: </strong>Victim mentality, because we have a choice to choose our mindset and approach to life, regardless of our personal history. </p> <p> <strong>Recommended reading: </strong>Favorite leadership book: "Dare to Lead," by Brene Brown. This book sparked a deep desire to empower others to lead with courage, vulnerability, and integrity. Favorite book to recommend to women and girls, regardless of age or profession? "Playing Big: Practical Wisdom for Women Who Want to Speak Up, Create, and Lead," by Tara Mohr. This book changed my life and inspired me to become a coach. I share this book with all my friends, mentees, and coaching clients. If only I could have read this book 25 years ago! </p> <p> <em>This article was featured in the November/December 2022 issue of WSMA Reports, WSMA's print magazine.</em> </p> </div>11/8/2022 12:00:00 AM1/1/0001 12:00:00 AM
problems-on-the-pathwayProblems on the PathwayLatest_NewsShared_Content/News/Latest_News/2022/problems-on-the-pathway<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2022/november-december/nov-dec-2022-reports-cover-645x425px.jpeg" class="pull-right" alt="cover illustration for WSMA Reports November/December 2022" /></div> <h5>November 7, 2022</h5> <h2>Problems on the Pathway</h2> <h5> <em>Members only; sign-in required.</em> </h5> <p> By Rita Colorito </p> <p> Prior to COVID-19, applications to the University of Washington's Summer Health Professions Education Program hovered in the low 800s, healthily exceeding the program's 80-student mandated minimum. Then COVID-19 hit, forcing the program to go virtual in the summer of 2020. By 2022, despite moving to a hybrid approach, the number of program applicants dropped nearly 50% to 433. </p> <p> UW is one of 12 locations nationwide that offers the free Robert Wood Johnson Foundation program for college students aimed at increasing diversity in the health professions. Of 3,282 students participating in the Summer Health Professions Education Program from 1989 to 2020, 30% have matriculated to medical schools as of March 19, 2021. It's one of several pathway programs in Washington state that encourage understanding of and participation in health care professions by focusing on pre-college students from underrepresented communities. </p> <p> Estell Williams, MD, executive director of UW's Center for Workforce Inclusion and Healthcare System Equity, worries the sharp decline in applicants isn't only a function of the pandemic, but another sign that the pathway to medical professions, particularly for underrepresented people, is in trouble and will get worse without focused intervention. "There's a one-to-one correlation between the decrease in college enrollment and what we're starting to see in supplemental programs that feed off of college enrollment," says Dr. Williams. </p> <p> In her role as a WSMA Foundation board member, Dr. Williams helped to sound the alarm, knowing that workforce and health equity issues are WSMA priorities. During the coming legislative session, the WSMA is supporting increased funding for residencies to attract more young physicians to train in Washington. "Whether through financial support for local residency programs or loan repayment to draw physicians into underrepresented areas, the WSMA is advocating federally and at the state level for growing our workforce," says Jennifer Hanscom, CEO of the WSMA. "That advocacy has expanded in recent years to include being intentional about building a physician population that mirrors our patient community as a step toward addressing racial inequities in health care." </p> <h3>What the data shows</h3> <p> Dr. Williams' concern is based on startling national and local data. The big picture: By 2034, the American Association of Medical Colleges estimates the U.S. could see a shortage of between 37,800 and 124,000 physicians, in both primary and specialty care. The backdrop: The pandemic accelerated a decade-long decline of 13% in student enrollment at the undergraduate level. As of spring 2022, there were nearly 1.4 million fewer undergraduate students, a drop of 9.4% from spring 2020, according to the National Student Clearinghouse Research Center. In Washington state, overall enrollment in post- secondary institutions dropped 11% from spring 2020 to spring 2022. </p> <p> How declining undergraduate enrollment will impact enrollment in medical school, and the number of physicians in the workforce, remains to be seen. Because the pathway to becoming a physician is long, now is the time to address the challenges, says Suzanne Allen, MD, MPH, UW's vice dean for academic, rural, and regional affairs. "When we see these downward trends early on, we need to address them in some fashion before they completely play out." </p> <p> When it comes to achieving health equity and representation among physicians, the NSCRC reports some troubling trends. Community colleges, often an on-ramp toward a four-year degree for underrepresented and lower-income students, experienced the biggest enrollment drop, losing more than 827,000 students since spring 2020. And while spring 2022 saw a return to pre-pandemic freshman undergraduate enrollment overall, not all demographic groups experienced upswings. </p> <p> Black freshman enrollment continued to see declines, with an overall decrease of 18.5% from spring 2020 to spring 2022. For Hispanics, spring 2022 freshman enrollment increased by 4.2% over spring 2021, but overall freshman enrollment is down by 3.8% since the start of the pandemic, threatening progress made. Hispanics, a population with the lowest degree attainment of any racial or ethnic group in the U.S., according to the Chronicle of Higher Education, had been the fastest-growing demographic enrolling in college over the last two decades. </p> <p> "Whenever we see any sort of economic recession or educational strike within our overall society, we know that is going to have a compound impact on our communities of color," says Dr. Williams. "We know from all of this data that it's going to further widen our inequities and getting these students into professional schools." </p> <h3>The challenge for medical schools</h3> <p> The boost from the "Fauci effect"-the record-setting 18% increase in medical school applicants for the 2021-2022 school year inspired by Anthony Fauci, MD, the then-director of the National Institute of Allergy and Infectious Diseases-also appears short-lived. It's also not clear whether the dramatic increase among Black and Hispanic applicants, each accounting for nearly 12% of that surge, will be repeated. </p> <p> Nationwide, medical school applications for the 2022-23 school year are coming in closer to pre-pandemic levels, according to AAMC. The return to prior levels is true for recent applicants to the UW School of Medicine, based in Seattle, and to Washington State University's Elson S. Floyd College of Medicine, based in Spokane, both of which experienced increases during the pandemic. </p> <p> One thing is certain: The pandemic further worsened disparities in underrepresented communities, says Dr. Allen. "Even those students who were in college during the pandemic, if they were from underrepresented communities, it was harder for them to continue in a virtual format. Maybe they struggled with internet access. Or they had to take care of a family member who got sick," she says. "So, are we going to see a decrease in applications from individuals who are underrepresented in medicine? Maybe, because they struggled to get through college." How this affects progress on health equity goals throughout the state of Washington remains to be seen, says Dr. Allen. </p> <p> For now, medical school enrollment has yet to see a negative impact from the long-term decline in college enrollment, says Leila Harrison, PhD, senior associate dean for admissions and student affairs for the Elson S. Floyd College of Medicine. She credits the college's unique admissions model with buffering it from potential applicant downturn and for promoting a diverse student body. </p> <p> That model focuses on students who are from or reside in Washington state, with an emphasis on those who either come from or have served rural and underserved communities. "Our admissions [policy] is directly linked back to our mission-to serve all the communities in Washington and help solve challenging health care problems that exist within rural and underserved communities," says Harrison, who advocates at the national level for a holistic review of medical school applicants. "Even given those restrictions, we still receive around 1,400 applications for 80 seats ... so, we have more than enough that we're considering every year." </p> <p> Despite a state law that prohibits public colleges from considering race or ethnicity in admissions, 17.5% of the WSU medical school's fall 2022 class are underrepresented in medicine by race or ethnicity. "I think for future applicants for medical school, when they see that we're enrolling such a diverse student body, they begin to see themselves here, as a place where they belong," says Harrison. </p> <p> Unlike traditional admission models which rely heavily on direct-from- college applicants, the Elson S. Floyd College of Medicine tends to enroll older students. Its average starting age for fall 2022 is 27. Where applicants completed their undergraduate studies also doesn't factor into the admissions equation, says Harrison. "We need to move medical education away from this traditional idea that only a certain group of people can aspire or have access to medical education." </p> <h3>Making inroads</h3> <p> Addressing underrepresentation in medicine needs to start at the earliest ages, says Mirna Ramos-Diaz, MD, chief diversity and inclusion officer for Pacific Northwest University of Health Sciences in Yakima. "For our Latinx students, by the time they're in fourth grade, they've already learned that science is not for them, because the message is never spoken to them," she says. </p> <p> PNWU's Roots to Wings Transformative Co-Mentoring Program is trying to change the experience of youth in the Yakima Valley who feel the medical profession is outside their reach. The program, which began in 2014, pairs sixth through 12th graders with health care students from PNWU. The medical school also offers an intensive summer research program for rising high school juniors and seniors. </p> <p> PNWU has only begun tracking long-term results for the co-mentoring program, but some 98% of summer research program graduates are now in college. And at least one graduate from the inaugural co-mentoring program is now a first-year medical student, says Dr. Ramos-Diaz. </p> <p> Like the drop seen by UW's pathway program, the Roots to Wings program, which takes place during the school year, also saw a steep decline in enrollment as a result of the pandemic, says Dr. Ramos-Diaz, the program's director. "They were tired of being on Zoom. They wanted to be in person, because they felt good about themselves here ... COVID was heartbreaking for our students," she says. The program returned to in-person learning this October at pre-pandemic levels. To date, more than 450 students have completed the Roots to Wings program. </p> <p> Like Dr. Williams, Dr. Ramos-Diaz is also concerned about the drop off in college enrollment, especially among underrepresented communities. "What we are trying to do is support that earlier entry in medical professions with these programs," she says. "Our youth are our future. We have to support them. We have to welcome them and let them know they belong, that they are capable." </p> <p> The Elson S. Floyd College of Medicine has developed several formal pathway programs for high school and college students who have an interest in medicine. "What we're doing with our pathways programs and our mission is aligned with our admissions process," says David Garcia, assistant dean for health equity and inclusion for the college. </p> <p> Most of these programs continue to have increases in applications and enrollment, including during the pandemic, says Garcia. The one exception was the Dare to Dream Health Science Academy, which focuses on migrant youth. "We saw a little bit of a decline there, but much of that had to do with transitioning to online," says Garcia. "Many of our migrant scholars live in the most rural areas and even in 2022 we still struggle to get a strong internet connection. Without internet it can be difficult to participate." </p> <p> Learning experiences are centered on the participants, says Garcia, reinforcing the concept of "If we can see it, we can be it." To further resonate with students, the programs engage them in critical work focused on improving conditions in their own communities, says Garcia. "A lot of the youth we work with have a passion for wanting to see social change." </p> <p> The pathway to medical professions needs more than stand-alone programs, says Garcia. "We'd like to think that our one- or two-week programs make a difference, and they do make a difference. However, it is the collective ecosystem that strengthens and supports students who are pursuing post-secondary education in the health sciences," says Garcia, who is currently in conversations with national medical educational groups to create pathways on a national scale. He's also involved in the Washington State BIPOC Health Careers Ecosystem, a volunteer-driven group of professionals dedicated to increasing the number of Indigenous, Black, Latinx, and Pacific Islander health professionals in the state. </p> <h3>What you can do to create pathways</h3> <p> "We should all be encouraging young people to look at health professions in the future. And then helping them know what they need to do to get there," says Dr. Allen. "WSMA members don't need to know all the steps. But they should be aware of the places that can help students find that information. And they should reach out to any of the three medical schools in Washington for help." </p> <p> Other ways to help include reaching out to local high schools, volunteering to talk to health classes about the medical profession, or participating in career days. </p> <p> "We know physicians already have a lot going on and they're burned out. So, I think that it's also extremely important for them to know that they're not alone," says Garcia. "We are here to partner with them. Many hands make for lighter lifting." </p> <p> Dr. Williams welcomes physicians to volunteer for the UW Summer Health Professions Education Program. "I'm scrambling trying to find people to provide shadowing or mentorships," she says. "If we truly want people to come into this profession to be here to take care of us, we have to be willing to open our doors and engage with students." </p> <p> For pediatricians and family physicians, encouraging the next generation can start with a simple conversation during yearly checkups, says Dr. Ramos-Diaz, who is also an associate professor of pediatrics at PNWU. "Keep on asking them, 'Where do you want to go to college?' Keep on believing in them and supporting their journey," says Dr. Ramos-Diaz, who often asked that of her young patients when she was in clinical practice. </p> <p> "If it wasn't for my family physician when I was younger telling me I could be a doctor, I wouldn't be where I am. So, I think that's super important," says Dr. Allen. </p> <p> To reach underrepresented communities, language matters. Both Garcia and Dr. Ramos-Diaz stress avoiding using the term "pipeline" to medical professions in favor of "pathways." "That resonates so much more with indigenous values and traditions, and life as a journey," says Dr. Ramos-Diaz. </p> <p> When talking to students interested in medicine, Garcia warns against using medical speak-a hidden barrier for many students. "The idea that all of this jargon that permeates academia and medical disciplines is common sense is extremely problematic. It's only common sense if you already know the answer," he says. "Physicians have the social and cultural capital to be bridge builders, not gatekeepers, in this space." </p> <p> How deep and sustained the decline in college enrollment and looming physician shortage will be depends on many factors. The worst outcome isn't inevitable, says Dr. Williams, who encourages WSMA members to become mentors. </p> <p> "As a profession, we're only as strong as those students who connect with us and can see themselves," says Dr. Williams. "The physician shortage is directly tied to how we invest in that next generation." </p> <p> <em>Rita Colorito is a freelance writer specializing in health care.</em> </p> <p> <em>This article was featured in the November/December 2022 issue of WSMA Reports, WSMA's print magazine.</em> </p> </div>11/7/2022 12:00:00 AM1/1/0001 12:00:00 AM
weekly-rounds-november-4-2022-five-things-to-know-before-year-endWeekly Rounds: November 4, 2022 - Five Things to Know Before Year-EndLatest_NewsShared_Content/News/Weekly_Rounds/2022/weekly-rounds-november-4-2022-five-things-to-know-before-year-end<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Weekly%20Rounds/Weekly-Rounds-Article-Graphic-2022-645x425px.png" class="pull-right" alt="Weekly Rounds logo" /></div> <h5>November 4, 2022</h5> <h2>Five Things to Know Before Year-End</h2> <p>Jennifer Hanscom, CEO</p> <p> Halloween, fall colors, chilly temps, shorter days...all point toward the holidays and a new year just around the corner. I'm sure, like mine, your days are getting busier and busier as we close in on 2023. But before we say farewell to 2022, here are five action items that may potentially affect you, so have a quick look below. </p> <h3>Help is available when disaster strikes</h3> <p> We're all breathing a little easier-quite literally-as right now there are no active fires in the state. We know that most of the state suffered from poor air quality throughout the past two months, and some medical practices may have suffered damage because of the earlier fires. </p> <p> I wanted to be sure you know about the AMA Foundation's new Disaster Relief Program that assists practices in FEMA-declared disasters. Washington was recently designated as such due to the recent fires. </p> <p> If your practice or community was impacted the fires or by any other declared disaster, you may benefit from the AMA program, which: </p> <ul> <li>helps individuals impacted by the disaster with medically related aid: medications, emergency first-aid stations, provision of other essential medical supplies, etc.; and/or</li> <li>assists physicians to rebuild practices in the impacted area.</li> </ul> <p> Of course, we hope this is never the case for our practices and communities, but should the need arise, be sure to reach out to the WSMA, who can put in a request on your behalf to the AMA Foundation. </p> <h3>Scholarship to increase physician diversity</h3> <p> We continue to incorporate equity efforts across all of WSMA's work, including the launch of a new <a href="">Scholarship and Diversity Advancement Fund</a> through the WSMA Foundation for Health Care Improvement. Our goal with this fund is to help build a more diverse physician population in Washington state by supporting students who are underrepresented in medicine. We know this is ambitious, but we are committed to changing the face of medicine in Washington state and creating a physician community that mirrors our patient population. </p> <p> Our goal with the fund is to cover full in-state tuition for four years of medical school for the scholarship recipient. We intend to raise $2 million to award the first scholarship, with a further goal to raise $5 million to award three scholarships (ideally, one for each of Washington's medical schools). </p> <p> Won't you join us in this fundraising effort? There are approximately 20,000 licensed physicians in Washington state. If every physician gave $250 to this endowment, we would meet our goal and could start issuing scholarships in the new year. The success of this effort depends upon your generosity and year-end giving is a great way to build a legacy. Donate now and get an additional tax deduction! <a href="">Donate online today</a>. </p> <h3>Take action on two pressing physician priorities</h3> <p> Don't miss these two federal action alerts in play that need your attention: One to <a href="">prevent a nearly 10% cut in Medicare payments in 2023</a> and one that will hold big insurance companies accountable by <a href="">requiring Medicare Advantage plans to adopt transparent prior authorization programs</a>. In both instances, there are promising bipartisan bills on the table-the Supporting Medicare Providers Act (H.R. 8800) and The Improving Seniors' Timely Access to Care Act (S. 3018)-but lawmakers in the Senate and House must hear from more physicians and physician assistant constituents to ensure their passage. Click on the links above to learn more about these action alerts and send your messages today. </p> <h3>Work accomplished and priorities ahead</h3> <p> WSMA's work on your behalf never ceases. We've summarized that work in our 2022 Impact Report, which will be in the mail to you soon. I hope you'll take a moment to look at that snapshot of our efforts and celebrate the major accomplishments in 2022. Our work is powered by you and your membership, so the successes you'll see outlined in the report are a testament to our member physicians and physician assistants who engage through the WSMA to make meaningful change in health care policy and the quality of care in our state. </p> <p> With the 2023 state legislative session beginning in January, we need you with us to maintain our momentum. This session we intend to continue our focus on increasing Medicaid rates for all specialties, standardizing and streamlining prior authorization, supporting legislation that benefits the health of our patients and our communities, and opposing efforts that interfere with the physician-patient relationship. </p> <p> Your membership drives the work we do. Thank you for your ongoing support of the WSMA as a new year of advocacy begins. You can <a href="[@]join-renew?_zs=B3aFd1&_zl=2fCg8">pay your 2023 dues online</a> today. We offer an easy autopay (monthly or yearly) option that you can choose at checkout. Also, remember that many of your medical groups cover WSMA membership. Be sure to check with your medical staff office or practice leadership about getting your WSMA dues reimbursed. Email <a href=""></a> for personal assistance. </p> <h3>Get informed and vote Nov. 8</h3> <p> Ensuring that the physician community's voice is heard in Olympia and Washington, D.C. starts at the ballot box. So, next Tuesday, Nov. 8, we strongly urge you to make your voice heard and vote. All 10 of the state's congressional House seats and more than 120 state legislative seats are up for grabs in key races that will shape the future of health care policy in Washington state. </p> <p> Before you cast your vote, take a moment to download the latest version of the <a href="[@]wsma/advocacy/wampac/wampac_legislator_report_card/wsma/advocacy/wampac/wampac_legislator_report_card.aspx?hkey=11823ee2-e48a-4214-af1a-fcad1da9d502&_zs=B3aFd1&_zl=3fCg8">WAMPAC Legislator Report Card</a> (sign-in required) so you can see how your legislators aligned with WSMA's priorities in the past couple of years. </p> <p> Speaking of WAMPAC, your financial support helps raise up the concerns of the house of medicine in our state. There is still time to join the <a href="[@]WSMA/Advocacy/WAMPAC/Give_to_WAMPAC.aspx?_zs=B3aFd1&_zl=4fCg8">WAMPAC Diamond Club</a> at a special rate of $100 for the duration of the membership cycle, culminating in November's election. Diamond Club members receive access to exclusive insider information about elections. And as a bonus, you'll receive a first-of-its-kind membership pin to recognize your contribution to WAMPAC. </p> <p> We believe physician leadership is paramount to good health care policy and patient care. Your voice and engagement make the difference. Thanks for all you do! </p> </div>11/4/2022 12:00:00 AM1/1/0001 12:00:00 AM
nov-8-is-general-election-day-be-sure-to-voteNov. 8 is General Election Day-Be Sure to Vote!Latest_NewsShared_Content/News/Membership_Memo/2022/october-28/nov-8-is-general-election-day-be-sure-to-vote<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/october/i-voted-stickers-645x425px.jpeg" class="pull-right" alt="I Voted stickers" /></div> <h5>October 28, 2022</h5> <!-- **************************NEW ARTICLE****************************** --> <h2>Nov. 8 is General Election Day-Be Sure to Vote!</h2> <p>Tuesday, Nov. 8, is General Election Day. By now, all Washingtonians registered to vote will have received their ballots in the mail. If you've changed your address or need to register to vote, there's still time: Monday, Oct. 31 is the deadline to register or update your address <a href="">online</a>. You may also register and vote in person at a county voting center through Election Day. </p> <p>We urge all members to make their voice heard and vote. Ensuring that the physician community's voice is heard in Olympia and Washington, D.C. starts at the ballot box. All 10 of the state's congressional House seats and more than 120 state legislative seats are up for grabs in key races that will help shape the future of health care policy in Washington state. In two of these races, WSMA-supported physicians are on the ballot: <a href="">Dr. Kim Schrier</a> in the 8<sup>th</sup>Congressional District is up for reelection and <a href="">Dr. Lelach Rave</a> is a first-time candidate for North Seattle's 46<sup>th</sup>Legislative District.</p> <p>Before you cast your vote, download the latest version of the WAMPAC Legislator Report Card <a href="[@]wsma/advocacy/wampac/wampac_legislator_report_card/wsma/advocacy/wampac/wampac_legislator_report_card.aspx?hkey=11823ee2-e48a-4214-af1a-fcad1da9d502">here</a> to see how your legislators aligned with the house of medicine. If you'd like to support WAMPAC's work, there is still time to join the <a href="[@]WSMA/Advocacy/WAMPAC/Give_to_WAMPAC.aspx">WAMPAC Diamond Club</a> at a special rate of $100 for the duration of the membership cycle, culminating in November's election. Diamond Club members receive access to exclusive insider information about elections. And as a bonus, you'll receive a first-of-its-kind membership pin to recognize your contribution to WAMPAC.</p> </div>10/27/2022 12:00:00 AM1/1/0001 12:00:00 AM
reminder-cme-other-licensing-requirements-reinstated-as-of-oct-27Reminder: CME, Other Licensing Requirements Reinstated as of Oct. 27Latest_NewsShared_Content/News/Membership_Memo/2022/october-28/reminder-cme-other-licensing-requirements-reinstated-as-of-oct-27<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/october/steth-warm-background-645x425.jpeg" class="pull-right" alt="stethoscope" /></div> <h5>October 28, 2022</h5> <h2>Reminder: CME, Other Licensing Requirements Reinstated as of Oct. 27</h2> <p>Gov. Jay Inslee's <a href="">Proclamation 20-32</a>, which extended certain licensing flexibilities to licensed health care professionals during the pandemic, ended this Thursday, along with waivers and holds on continuing medical education requirements.</p> <h3>CME requirements </h3> <p>As a reminder to WSMA members, the Washington Medical Commission will exercise enforcement discretion for MDs and physician assistants regarding the resumption of CME requirements, including instating a grace period for MDs and PAs to complete their CME requirements. See <a href="[@]Shared_Content/News/Membership_Memo/2022/august-26/washington-medical-commission-announces-grace-period-for-cme-requirements-.aspx?_zs=A3aFd1&_zl=vJ5X8">this Membership Memo article for a timetable of CME attestation requirements</a>.</p> <p>In a recent notice, the Washington Medical Commission indicated it has received questions regarding the required suicide prevention training. Visit the commission's website for FAQs regarding <a href="">Suicide Assessment, Treatment, Management Training</a>. For a specific list of training courses visit the <a href="">Department of Health model list webpage</a>.</p> <p>For our DO members: The Board of Osteopathic Medicine and Surgery will excuse osteopathic physicians from attesting to completion of CME requirements as a requirement for license renewal until they have completed their next full CME cycle after Oct. 27, 2022. “Full cycle” means the full timeframe for completing CME, which is three years for osteopathic physicians. This will assure osteopathic physicians have ample time to meet CME requirements for license renewal.</p> <h3>Waivers by profession</h3> <p>Effective Oct. 27, the following requirements have been reinstated:</p> <ul> <li>Physician assistants - physician supervision ratios and delegation agreement requirements.</li> <li>Limited license holders - restrictions regarding geographic locations or specific jobs as described in their appointments.</li> <li>Retired active MD and DO licensees - restrictions that include not receiving compensation for health care services and only practicing in emergent or intermittent circumstances.</li> <li>Retired active PA licensees - requirements to have a delegation agreement and will be prohibited from receiving compensation for health care services.</li> </ul> <h3>For questions or more information</h3> <p>For questions regarding the rescission of waivers and the return of CME, contact the Washington Medical Commission Licensing Unit at 360.236.2750 or <a href=""></a>, or watch this <a href="">informational webinar</a>. For our DO members, email <a href=""></a> or call 360.236.4700.</p> </div>10/27/2022 12:00:00 AM1/1/0001 12:00:00 AM
wsma-backs-texas-medical-associations-latest-no-surprises-act-lawsuitWSMA Backs Texas Medical Association's Latest No Surprises Act LawsuitLatest_NewsShared_Content/News/Membership_Memo/2022/october-28/wsma-backs-texas-medical-associations-latest-no-surprises-act-lawsuit<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/october/bill-oxford-oxghu60nwxu-unsplash-645x425px.jpeg" class="pull-right" alt="gavel" /></div> <h5>October 28, 2022</h5> <h2>WSMA Backs Texas Medical Association's Latest No Surprises Act Lawsuit</h2> <p>The WSMA has joined with other state medical and medical specialty associations in signing on to an amicus brief supporting a new Texas Medical Association lawsuit challenging the independent dispute resolution provisions of the federal No Surprises Act, the latest volley in an ongoing debate over the implementation of the balance billing legislation.</p> <p>The brief, filed this month by the Physicians Advocacy Institute, supports TMA's legal challenge filed in September, which alleges that federal regulators, when issuing a final rule implementing the independent dispute resolutionprovisions, violated the No Surprises Act by giving preference to the "qualifying payment amount," which unfairly favors insurers when settling payment disputes between physicians and payers. This flawed approach was struck down by the Eastern District of Texas earlier this year before federal regulators sidestepped the court's decision in the final rule.</p> <p>The WSMA continues to hear from physician groups struggling with the No Surprises Act, primarily due to changes in carrier contracting practices resulting from the more favorable independent dispute resolution process. In many of these cases, carriers are less willing to contract with physician groups on reasonable terms as they perceive they'll be successful in disputes with out-of-network physicians.</p> <p>If allowed to stand, the federal regulators' approach will encourage even more health care consolidation and give insurers an unfair advantage contracting with physicians. This will further constrict already narrow, insurer-built networks of physicians and clinicians, raising serious concerns about patients' ability to access affordable, quality specialty care.</p> <p>TMA's lawsuit and the supporting amicus brief do not challenge the No Surprises Act's critical patient protections, which went into effect in January of this year and which physicians strongly support. The WSMA will keep members apprised of developments as the legal challenge proceeds.</p> </div>10/27/2022 12:00:00 AM1/1/0001 12:00:00 AM
weekly-rounds-october-21-2022-new-physicians-insurance-endorsement-reflects-changing-medicalWeekly Rounds: October 21, 2022 - New Physicians Insurance Endorsement Reflects Changing MedLatest_NewsShared_Content/News/Weekly_Rounds/2022/weekly-rounds-october-21-2022-new-physicians-insurance-endorsement-reflects-changing-medical<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Weekly%20Rounds/Weekly-Rounds-Article-Graphic-2022-645x425px.png" class="pull-right" alt="Weekly Rounds logo" /></div> <h5>October 21, 2022</h5> <h2>New Physicians Insurance Endorsement Reflects Changing Medical Liability Landscape</h2> <p>Jennifer Hanscom, CEO</p> <p> Co-authored by Physicians Insurance CEO Bill Cotter </p> <p> The medical community held its collective breath during the trial of RaDonda Vaught, a nurse at Vanderbilt University Medical Center who was found guilty of criminal charges of gross neglect and negligent homicide for administering the wrong medication to a patient-a medical error that led to the patient's death. The case was highly publicized, in part due to the unusual decision to pursue criminal charges in a case where there was no demonstrable malicious intent or impairment. For many in health care the case represents a worrying turn of events for medicine-the criminalization of medical practice. </p> <p> A judge once said "Doctors would not be able to save lives if they were to tremble with the fear of facing criminal prosecution." Indeed, since the Institute of Medicine's landmark 1999 report "To Err is Human" brought a sharp focus on medical errors, the emphasis has been less on punishment and more on learning from mistakes-a paradigm which encourages transparency and quality improvement. </p> <p> Today, physicians and hospitals are operating in an extremely stressful and pressure-filled environment; one that is made even more difficult as they now navigate the legal ramifications of increased criminal medical negligence claims as seen in the Vanderbilt case, the potential for criminal state claims arising out of the U.S. Supreme Court's decision in Dobbs v. Jackson Women's Health Organization, and the subsequent state criminalization of health care practices that have long been the professionally accepted standard of care. </p> <p> Witnessing the change, our homegrown medical liability company, Physicians Insurance A Mutual Company, staying true to its mission of protecting and defending its members, has announced the launch of new <a href="">criminal defense reimbursement coverage</a>. The new coverage allows for support for defense costs incurred when a physician or hospital is responding to a criminal allegation arising from patient care. </p> <p> While medical professional liability policies have historically excluded coverage for criminal actions, Physicians Insurance's new coverage reflects its commitment to protecting and defending health care professionals as they pursue their life's work practicing quality medicine. </p> <p> The new coverage expressly responds to reimburse defense costs up to $250,000 (without eroding limits of main policy) when criminal actions arise from direct patient care. We believe this first-of-its-kind coverage will better support physicians and hospitals amongst today's changing professional liability trends and recent changes in law creating circumstances where physicians and health care professionals may face criminal liability for doing their jobs. </p> <p> This is not about protecting criminals or criminal behavior as defined by law. If an individual is found guilty and has exhausted their appeal rights on the issue of guilt, further reimbursement will not be made, and Physicians Insurance will retain the right to recover funds already paid. </p> <p> The new criminal defense reimbursement coverage supplements any other coverages purchased under the medical professional liability or hospital liability policy. A civil suit and a criminal proceeding are handled separately, following different procedural rules and proceedings, even if both arise out of the same set of facts. The coverage limits available under the underlying policy will remain available for the civil liability suit, and the separate limits under the criminal defense reimbursement will remain available for the criminal proceeding. Health care disciplinary board coverage will also remain available under the underlying policy. </p> <p> It is unfortunate that we find ourselves in a time when such coverage is needed. But this concerning shift in the medical legal community, accusations of criminal actions that come from providing direct patient care, including performing abortions, must not go unnoticed. We fear that this shift to criminalize patient care could have repercussions on the treatment and care physicians provide. </p> <p> *If you are insured by Physicians Insurance, this new coverage will be automatically added to your renewal starting Jan. 1, 2023, unless you opt out. To learn more, go to <a href=""></a>. </p> </div>10/21/2022 12:00:00 AM1/1/0001 12:00:00 AM
secretary-of-health-shah-extends-medical-assistant-practice-flexibilitiesSecretary of Health Shah Extends Medical Assistant Practice FlexibilitiesLatest_NewsShared_Content/News/Membership_Memo/2022/october-14/secretary-of-health-shah-extends-medical-assistant-practice-flexibilities<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/october/stethoscope-on-table-645x425px.jpeg" class="pull-right" alt="stethoscope on a table" /></div> <h5>October 14, 2022</h5> <h2>Secretary of Health Shah Extends Medical Assistant Practice Flexibilities</h2> <p>Washington State Secretary of Health Umair A. Shah, MD, MPH, has issued a <a href="" target="_blank" rel="noreferrer">Public Readiness and Emergency Preparedness Act authorization</a> allowing a medical assistant-registered and medical assistant-certified to perform COVID-19 tests and administer COVID-19 vaccines without an on-site supervisor. MA-Cs and MA-Rs are required to have a supervising health care practitioner who is "immediately available" to them.</p> <p>This flexibility in utilizing MA-Cs and MA-Rs, currently allowed under Gov. Jay Inslee's proclamation 20-32, which is set to terminate Oct. 27, has been a benefit to many practice settings to ensure timely access to COVID-19 vaccines and tests. Without the PREP Act authorization, state law would have reverted to requiring the supervising practitioner to be physically present and immediately available in the facility when the MA-R or MA-C is performing these duties.</p> <p>This PREP Act authorization also allows MAs to administer products to treat serious conditions caused by tests or vaccines (e.g., epi autoinjectors), subject to normal requirements in state law. Many thanks to Secretary Shah for listening to the WSMA and many others in the physician and practice community who have advocated for this flexibility.</p> </div>10/14/2022 12:00:00 AM1/1/0001 12:00:00 AM
weekly-rounds-october-4-2022---caring-community-and-cowsWeekly Rounds: October 4, 2022 - Caring, Community, and CowsLatest_NewsShared_Content/News/Weekly_Rounds/2022/weekly-rounds-october-4-2022---caring-community-and-cows<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Weekly%20Rounds/weekly-rounds-article-graphic-katina-rue-645x425px.png" class="pull-right" alt="Weekly Rounds logo" /></div> <h5>October 4, 2022</h5> <h2>Caring, Community, and Cows</h2> <p> Katina Rue, DO, FAAFP, FACOFP, WSMA President </p> <p> <em>Dr. Katina Rue shares the lessons she's applying to her presidency in her inaugural address on Sunday, Oct. 2, 2022.</em> </p> <p> It's great to be with you here in Spokane for the opening session of our 2022 meeting of the House of Delegates. Were you all up early this morning reading the reference committee reports? I know I was! </p> <p> As your new president, there are a few things you should know about me. Like you-like each of us-I'm different! </p> <p> Here are a few ways I'm different: Most of you here are MDs. Well, I'm a DO and to the best of our knowledge, I'm likely the first DO to be president of the WSMA! Let's see a raise of hands from any other DOs represented here today! </p> <p> I'm Latina and quite possibly the first Latina to be WSMA president. Who's here who identifies Latinx? Raise your hands! </p> <p> Also, I'm a farm girl. I live in an old stone house on five acres near Yakima with my husband, Aureliano, our daughter, Valeria, a bunch of cows, an occasional sheep, and loads of fruit trees. Let's see it: Anyone else out there live on a farm? </p> <p> Even with these differences, I know we have plenty in common as well: We're all passionate about quality care for our patients, about staying well ourselves so that we can care for others, and about being called to medicine as a profession. And like you, I suffered-and survived-my way through the pandemic and all of its fallout. </p> <p> There were hard moments along the way-some devastating, some inspiring. I'm sure you can identify: Seeing communities of color disproportionately affected by COVID. Seeing physicians, PAs, and staff lead with service above self. Seeing neighbors, friends, and families divided over issues big and small. Seeing colleagues help each other find a healthy path forward, with mind, body, heart, and soul intact. </p> <p> Getting through it all for me meant that I had an opportunity to learn new skills, grow into leadership and face my fears. I've even learned to embrace all that. I mean, I'm standing up here, aren't I? Public speaking has never been on my bucket list! And so, here I am, and I want to share three of lessons that I believe can make a difference in our year together. </p> <p> The first is summed up in a line from a poem by Mary Oliver: "Listen-are you breathing just a little, and calling it a life?" </p> <p> Take a second and hear that line again: "Listen-are you breathing just a little, and calling it a life?" </p> <p> Those words really hit me hard, because in early 2021, it dawned on me that I was only "breathing just a little" and I was calling it a life. I realized I had to take action. I quit my job and took the whole summer off to regroup and refocus my career. The pandemic had worn me down. Stress was taking its toll. I was burned out big time. I knew I needed to reenergize my soul, my life, and my work. I took time to enjoy our farm-the cows, bees, and trees-and my family. Being at the farm with my family feeds my soul-it was just what the doctor ordered. </p> <p> As I reflect on the pandemic years, I know many of you have faced-or are facing-burnout. Maybe you're even feeling like I did-that you're "breathing just a little." Our schedules are packed, time with patients too limited, prior authorizations weigh us down, the hours are too long. More than that, we face external pressures from administration, government, insurance carriers, and regulatory entities-all of which steal time from patient care. </p> <p> And yet, we persevere. We show up to bring health and healing to our patients. We make a difference. </p> <p> Are you "breathing just a little and calling it a life"? You're not alone. I encourage you to reach out and let us know how we can help. I want you to know that everything we do at the WSMA drives toward supporting and advocating for you. We are dedicated to strengthening physician wellness and restoring the joy of practice. Ours is a caring profession-it only makes sense to care for ourselves to ensure we are well enough to care for others. </p> <p> Second, I've learned that TEAM means that "Together Everyone Achieves More." </p> <p> That's a quote from Robert Rohm, who is known for his work on the DISC personality insights training. I've participated in DISC at work and learned a few things about myself. Everyone has a combination of these traits, of course. I'm a "D-I" which means I'm direct and an "influencer." These traits mean that I'm quick to respond, I'm comfortable making decisions in order to move forward, and I can be charming at the same time. As it turns out, I can also be blunt and a control freak-I'm working on all that! </p> <p> Through all this leadership development work, I've been reminded that the leader doesn't have to take everything on themselves. I've learned to better delegate, and to inspire and trust the people around me. A work in progress, for sure! </p> <p> Still, I've learned that together, everyone achieves more. I find that to be true in organized medicine as well. I believe in getting engaged in our profession and in having physicians lead the way in health care. If we don't lead, others will step in to fill the gap. </p> <p> When I was in medical school, I saw my mentors-both faculty and community physicians-modeling involvement in their state osteopathic and allopathic medical associations. I stepped into organized medicine partly because I saw them doing it. And when I came to Washington, it was a natural progression to get involved in the WSMA. I wanted to be part of that passion and commitment to communities, patients, and medicine that I had been part of in Missouri. </p> <p> You're all here today because you care about organized medicine, and you see that it makes a difference. Later this morning, you'll be voting on important policies that will guide the work of the WSMA. But guess what? We don't just do this work here during the Annual Meeting. We are busy doing this work all year long! I'm inviting you to get engaged and help lead the way. Together we are stronger and there is strength in numbers. I encourage you to step up and step into the action. </p> <p> Which brings me to the third thing I've learned: Live like someone left the gate open! </p> <p> I did tell you I'm a farm girl! I'm also obsessed with cows. Who knows why, but I've been crazy about cows ever since middle school in Sequim. No one in my family had cows, but still I was all about cows, cows, cows. Holsteins, Jerseys, Guernseys, Herefords, Highlanders, Dutch Belted, and Charolais…I love them all. Today, we have five cows on our farm. And just so you know, yes, we do name them, and no, we don't eat them! </p> <p> Farm livin' definitely takes a village. We help our neighbors, and they help us. Just over a month ago, Nano and I were out in the pasture helping our heifer, Estrella, birth her calf. Usually cows give birth with ease, but Estrella was having a very hard time getting baby Luna to come out. We had to call for help from our neighbor, who came running. </p> <p> There we all were: mama cow, Nano, the neighbor, and me, literally up to my shoulder inside Estrella. The calf's head was stuck. With some perineal massage, gentle pressure, and two strong men, we were able to pull baby Luna after 60 minutes! Today, mama Estrella is still struggling to gain weight (she's been having postpartum complications) and baby Luna is growing up quite nicely. </p> <p> What does my cow story have to do with anything? Well, it's just that I've learned so much from my cows and my farm and my community. </p> <p> I started this speech talking about the ways in which I'm different. Throughout my life, those differences sometimes felt limiting-as though an electric fence might zap me if I stepped out of my lane. I know others who've felt the same way-women like Astrid Strasik, a fourth year Latina medical student who is not able to be here today, but is making a difference as part of the Medical Student Section! </p> <p> She wrote an article in the latest WSMA Reports-in part, here's what she wrote: "As a Latina walking into a space historically occupied by predominantly white male faces, I am frequently overwrought by feelings of inadequacy. I await the moment I am 'outed' as an imposter, even as I stand in my white coat in the hallways of the hospital." </p> <p> I so identify with her feelings of potentially being "outed as an imposter!" But at the same time, I know this: Diversity is beautiful. Diversity is the art of thinking independently together. </p> <p> I am proud of the work the WSMA is doing right now to ensure that all member voices are heard, as well as our commitment to health equity and eliminating disparities in health care. Already that work is yielding tangible change. Here are just a couple of tangible examples: </p> <ul> <li>This year, WSMA President Mika Sinanan implemented a DEI committee, which has ensured diverse voices are at the table. As you review the resolutions today before the House, you will find we have added a DEI note to every resolution, so that we can consider how the policies we set might affect underrepresented communities.</li> <li>An engaged group of WSMA members joined together to create a Latinx Advisory Council and we hope to add more interest groups soon.</li> <li>The WSMA Foundation added health equity to its strategic plan, and as heard yesterday, has implemented a significant scholarship fund for diverse medical students.</li> </ul> <p> We're excited about all of this, even as we know there is so much more to be done. We're also realistic, recognizing that real change takes time and intention. Even so, the WSMA is committed to working on beautiful diversity for the long haul. </p> <p> Did you notice the song playing when we first came into the room this morning? It's called "<a href="">There's Room at the Table</a>," by a folk singer named Carrie Newcomer. The repeating lyric is "there's room at the table for everyone!" I know this to be true. My cows taught me that we need the village around us. And rather than being fenced in, we need to shake off those limitations and take off running. </p> <p> Let's live like someone left the gate open! </p> <p> Thank you! </p> </div>10/4/2022 12:00:00 AM1/1/0001 12:00:00 AM
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